Early Administration of Propofol without Intubation in Status Epilepticus; Dosage, Safety and Outcome.
Abstract number :
1.194
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2016
Submission ID :
194935
Source :
www.aesnet.org
Presentation date :
12/3/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Abdullah S. Alamri, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; Abdulrahman Alturki, McGill University; Karina A. González-Otárula, Montreal Neurological Institute and Hospital, McGill University, Canada, Montreal, C
Rationale: Status epilepticus (SE) is a neurological emergency requiring immediate evaluation and treatment. Duration of SE, the number of anti-epileptic drugs administered, potential systemic complications in addition to the need for the intubation when using anesthetic drugs, all could potentially affect clinical outcome. We report the Montreal Neurological Hospital - neurocritical care unit (MNH-NCCU) clinical experience in treating SE with early administration of Propofol without intubation. Methods: This is a retrospective single center analysis of all adult patients admitted to the MNH-NCCU between January 2005 to January 2015 with the diagnosis of SE. All patients were assessed with clinical examination and laboratory investigation - including continuous Video-Electroencephalographic monitoring (V-EEG) Results: Forty-seven episodes of SE were reviewed in 28 patients; median age was 49 years. In 29 episodes, convulsive SE was the diagnosis on admission, and non-convulsive SE in 18. In 23 episodes, Propofol was administered early without the need for intubation. In another 24 episodes, patients had been intubated prior to referral. Of those, 12 were extubated upon admission to the NCCU without interrupting the Propofol infusion. The loading dose of Propofol used was 1 mg/kg, and maintenance ranged from 12.5 to 50 mcg/kg/min. Duration of use of Propofol without intubation ranged from 9 hours to five days. Only one patient was re-intubated after extubation because of O2 desaturation. No mortality, significant hemodynamic disturbances, or Propofol related side effects were reported. The length of stay in the NCCU was 1-2 days in 57.4%, 3-6 days in 25.5%, and up to 20 days in 8.5%. Data was missing for the remaining 8.5%. Total stay in the hospital was less than a week in 51.1%, 1-2 weeks in 21.3%, and 2-7 weeks in another 21.3%. Data was missing for the remaining 6.3% Conclusions: Early administration of sub-anesthetic concentrations of Propofol for SE patients appears to be safe, and might reflect positively on the outcome. Prospective studies are warranted Funding: None
Clinical Epilepsy